‘If you terminate me, I will ruin your life’

I do not feel unfortunate to be from the Middle East—despite having lost many opportunities because of it.Being from there enriched my ability to understand people’s personalities and behaviours—mainly Middle Easterners as I continue to practice medicine and serve my patients from all over the world.We, as people from the Middle East, have endured harsh lives amidst wars and the tyranny of dictators, which has instilled in us a sense of fear and insecurity. Therefore, we try in one way or another to defend ourselves if we sense any danger even if it’s imaginary, or unjust even if doesn’t exist. Hence, the first thing many would do, if they can, is to resort to using the language of threat, believing it to be the only language that preserves their identity, existence and dignity. This language is what we have heard in the past and encoded for decades.As a result of all this, two types of people emerged: some adopt this language and use it because it has yielded positive results in the past, while others cannot stand hearing it because it was imposed unfairly. I belong to the latter type; I hate this language and cannot tolerate hearing it. I consider it a tactic of the weak, used either by those who are weak and incapable of negotiation, or by those who exploit their power or the power of others to intimidate. In both cases, it is a despicable language devoid of manners and respect.Read: Dr. Jabir Jassam: We’re the frontline—not the front deskWhat’s interesting is that sometimes this language comes from people from the Middle East directed towards doctors from the Middle East! It is like they assuming that these doctors are still easily intimidated and by hearing this language they will fear and comply with the person’s demands and needs. I have never heard of a patient from the Middle East threatening a non-Arab doctor that they would file a complaint against them or ruin their life if they refused to perform a nonindicated exam (now maybe it happens a lot but I don’t know about it). Nor have I heard of such when a doctor terminates a relationship for legitimate reasons or tells a patient that they cannot have an appointment that day due to a full schedule. Perhaps they realize that this language will not be effective, and they think it will work with Middle Eastern doctors because the language of threat has been prevalent back home.My personal issue, or perhaps it’s my right, is that if someone threatens me, I lose the ability to deal with them. Therefore, to avoid complications that may arise in my professional field, I end my relationship with anyone who threatens me as quickly as possible.Over time, it has become expected for me to hear threats here and there from many for very trivial matters, such as not sending them for the test they want, informing them that there is no need to refer them to another speciality or if I inform them about the downsizing of my practice.NasifMy encounter with Nasif (not his real name) happened in October 2022, and I decided to write about it after his name came up again. “Nasif, my patients’ roster size has become very large, and became difficult to manage it. Therefore, I’ve decided to downsize my practice,” I said calmly. “What does that mean?” Nasif replied angrily.“I have to randomly select a large number of patients to send them a letter asking them to find another doctor.”“Am I one of them?” “Unfortunately, yes,” I said.Nasif scowled. “What am I supposed to do?” “You will find many doctors’ names in the letter that you can call and hopefully, they would agree to take you, especially since you are young and not on any medications,” I said, trying to calm him down.“No, you cannot do that!”“I understand your frustration, but I sadly have to do it, and here is your termination letter.” I handed him the letter.“I warn you, if you terminate me, I will ruin your life!” he snapped.“Uff, how would you ruin my life?” “Just do it, and you will see.”“So Nasif, even if I’m not downsizing my practice, do you think I would be able to work with you anymore?” I asked. “Yes, why not?” He threw the letter at me.“Nasif, do you know the consequences of your threat?” “I know the consequences, but you do not know the consequences if you let me go,” he said his voice shaking.“This is your letter of termination, and I will change your grace period. Your termination start date is today, not a month from now. I will inform the staff about your threat and the police as well (which I didn’t do). You will be responsible for anything that may happen to me in the future.” I left the room and never heard his name again until two months ago. Two months agoTwo months ago, I received a call from an Arab colleague whom I had never talked to before. He left his cellphone number at the front desk and requested that I call him back.I called him at night, we greeted each other, and he informed me that Nasif is under his care now, but things are not going well.“How can I help with that?” I asked.“What was the reason you terminated Nasif?” he asked anxiously.“I was downsizing my practice, so his name came up in a random selection.”“Has he ever complained against you to the college?” “Why?” “He wanted an MRI for his back with no indication, and when I advised him that there was no indication, he threatened to complain against me if I do not do it.”“Well, when I handed him the termination letter, he threatened to ruin my life.”“What did he do?” “He did nothing and he would do nothing to you as well.”“Are you sure?”“Of course,” I assured him.“What do you suggest I do?” “I won’t tell what to do, but if this happened to me, I would not send him for the MRI if not indicated and would end our physician-patient relationship.”“Do you think he would complain?”“Document your exam findings, his threat and do not worry. Even if he complains, which he won’t, the college investigators are fair and smart.”“Shall I terminate him?”“Up to you. If you think you can work with him and stay objective despite that, it means you are better than me.”We chatted for a while and ended the call.He texted me later stated that he terminated him.Dr. Jabir Jassam is a family physician in Ottawa.

‘If you terminate me, I will ruin your life’

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